William Dale Whitted O.D.

NPI 1013096122 - Optometrist - 152WL0500X

NPI Details
NPI 1013096122
Gender Male
Enumeration Date 11/02/2006
Last Updated 08/31/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1036 W ROBINHOOD DR
SUITE 105
STOCKTON CA, 95207-5623, US
Phone (209) 951-3693
Fax (209) 951-4711
Business Location
1036 W ROBINHOOD DR
SUITE 105
STOCKTON CA, 95207-5623, US
Phone (209) 951-3693
Fax (209) 951-4711
Toxanomy
Taxonomy Code 152WL0500X
License State California
License Number 5969T
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According to our database, Dr. William Dale Whitted O.D. NPI is 1013096122, taxonomy code is 152WL0500X and license number is 5969T, license state is located at California. William Dale Whitted O.D. physically located at 1036 W Robinhood Dr, Stockton CA, 95207-5623. NPI Number William Dale Whitted O.D. has the Individual type.

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1013096122 NPI number is provided on an as is basis without warranty of any kind. 1013096122 is maintained by the National Plan & Provider Enumeration System. The contents of William Dale Whitted O.D. are for informational purposes only.